Hospital Outpatient Departments Research Articles

PRACTICE OF SELF-MEDICATION IN NEPALESE PATIENTS PRESENTING IN ENT OUTPATIENT OF KIST MEDICAL COLLEGE TEACHING HOSPITAL

Background: Self-medication is a practice of using medications without prescription. It is a common practice in developing world like Nepal. The study aimed to assess the practice of self-medication in patients attending ENT and Head and Neck outpatient department of KIST Medical College and Teaching Hospital. Methods: A descriptive cross-sectional study was conducted from December 2019- August 2021. Total 220 patients attending the ENT outpatients during the study period were enrolled in the study. Informed consent was taken from the patients. The semi structured pretested questionnaire was used to interview the patients by the trained medical doctor. Statistical analysis of data was performed by using Excel and SPSS. Results: Among the 220(8.7%) respondents’ 52.7 percent were males and 47.3 percent were females. Adults with age ranging between 30 to 44 were found to practice self-medication (34.5%). Most of them were house wives (25.9%). The common reasons for practice of self-medication were mild illness (64.1%), and the main source of self-medication was chemist (73.6%). Conclusions: Self-medication is common practice in Nepal however our study indicates a decreasing trend of self-medication, especially in urban areas where access to health service is easy. The findings of the study indicate antibiotics are used more frequently as self-medication even in urban settings. This indicates misuse of access to medicines and can lead to rise of antibiotics resistant. So, we think national guideline should be prepared to make self-medication practice safe and rational.

Study on gender preference among pregnant women attending the tertiary care Hospital, Valsad: A cross-sectional study

Child sex ratio has been declining over a period of time. Preference for a male child by the family leading to sex selective abortion is found to be a major factor which may have adverse impact on the social structure. The social evil female feticide and infanticide can be eradicated only when we identify the reasons of gender preference and recognize the importance of women in their life. Preference for male baby reflects underlying socioeconomic and cultural patterns and prevailing inequity between genders in many societies in India. So this study was undertaken to find out the gender preference and various reasons for gender preference among antenatal women.This study was conducted among ANC mothers to know 1. Epidemiological factors of pregnant mother affecting the gender preference 2. Know the gender preference among ANC Mother for current pregnancy 3. Know the reasons for gender preference. A cross-sectional questionnaire based study was conducted among 100 antenatal women attending to Outpatient department of tertiary care hospital in the months of July-August 2021. Written consent was obtained after being briefed in detail about the aim and objectives of the study. Information was obtained using a pre-tested questionnaire on Demographic details, Obstetrics details, order of pregnancy, gender preference by the mother and reasons for gender preference etc. The data was entered and analyzed by using statistical software. In our study mean age of pregnant mother is 23±2SD, 15% mothers are illiterate and 58% from general category and 51% are residing in Nuclear family. 40.0% of pregnant mother had male gender preference and main reason for male gender preference was previous female child (60.0%), income purpose (57.50%), for generation constitution (45.0%) and demand of in laws (45.0%). We also noted the reason for non-preference of female child and noted that 87.5% had already a female child in their family.A desire for a balanced number of daughters and sons and a preference were observed. A son preference was observed among pregnant mothers for various reasons such as Income purpose, generation constitution, demand of in laws etc.

The Effectiveness of Community Aging Care Centers on Global Function for People Living with Dementia.

The global population with dementia is growing rapidly. Dementia patients have been included in the services of the long-term care Act 2.0, supported by Taiwan's government since 2017. Community aging care centers are extensively established, which are places providing social connections and group physical and cognitive training programs for elderly people. To elucidate the efficacy of community aging care centers on cognitive function in people with dementia. A total of 1,277 patients with dementia diagnosed at the Changhua Christian Hospital outpatient departments were enrolled. A total of 113 patients who used community aging care centers and 452 subjects matched for age, education, and initial score of clinical dementia rating scale sum of boxes (CDR-SOB) control group were analyzed. The primary outcome was the change in CDR-SOB scores before and after utilization of community aging care centers. The mean annual change of CDR-SOB scores were 1.72±2.97, 1.08±2.36, and 1.04±3.64 in control, Community Service Centers for Dementia, and community elderly stations, respectively, after about 1.5 years follow-up. Patients with dementia using community aging care centers had significantly less progression in CDR-SOB scores than those in the control group (-0.65; 95% CI: -1.27, -0.03; p = 0.041). Using one more day of community aging care centers per week significantly promotes 0.16 points of CDR-SOB decline (-0.16, 95% CI: -0.31; -0.00; p = 0.045). Community aging care centers, based on the long-term care Act 2.0 in Taiwan, were effective in delaying the decline in global function in people living with dementia.

US Generalist Physicians and Groups That Focused Practice in a Single Care Setting: 2014-2017.

Some generalist physicians whose training prepared them for primary care practice increasingly practice in a facility (eg, hospitals, nursing homes); however, whether this trend was accompanied by a complimentary rise in generalist physicians who focused their practice on office-based care is unknown. Our objective in this study was to examine trends in the prevalence of generalist physicians and physician groups that practice in a single setting. This was a retrospective cross-sectional study of generalist physicians trained in family medicine, internal medicine, or geriatrics. We used 2014-2017 billing data for Medicare fee-for-service beneficiaries to measure the proportion of all patient visits made by physicians in the following care settings: office, outpatient hospital department, inpatient hospital, and other sites. From 2014 to 2017, the proportion of generalist physicians who narrowed their practice to a single setting increased by 6.69% (from 62.80% to 67.00%, p for trend <0.001). In 2017, 4.63% of physician groups included more than 1 type of setting-based physicians. Generalist physicians treating older adults increasingly narrowed their practice focus to a single type of health care setting. This trend was not accompanied by growth among physician groups that included different types of setting-based physicians. Further evaluation of the consequences of these trends on the fragmentation of primary care delivery across different health care settings and primary care outcomes is needed.

Prevalence of Hypothyroidism in the Population of West Bokaro Coal Mine Area, Jharkhand: A Hospital-Based Observational Study.

BackgroundHypothyroidism is a common endocrine disorder worldwide. Studies on the prevalence of hypothyroidism in different geographical territories of India are sparse. Data on the prevalence of hypothyroidism in India's coal mine areas are lacking. Therefore, we conducted a cross-sectional study to determine the prevalence of hypothyroidism in the adult population living in the coal mine areas of West Bokaro, Jharkhand, India.MethodsIn total, 1484 individuals of both sexes attending the outpatient department (OPD) of Tata Central Hospital, West Bokaro, Jharkhand, with varied symptoms were screened for thyroid-stimulating hormone (TSH) levels from January 2021 to February 2022. The age of the study participants ranged from 15 to 80 years.ResultsIn total, 366 participants had hypothyroidism (subclinical as well as overt). The prevalence of hypothyroidism was greater in women than in men. Among the 366 patients with hypothyroidism, 311 were women and 55 were men, and the ratio was 5.5:1. The percentage of the population having hypothyroidism was 24% in this study, which is higher than that reported in other parts of India; however, our results are similar to those of a study conducted in Assam in 2017. Among patients with high TSH levels, 47%, 25%, and 19% had TSH in the range of 5.6-7.5, 7.6-10.6, and 10.6-20 μU/mL, respectively.ConclusionsSubclinical and overt hypothyroidism are common in eastern India. Patients with undiagnosed fatigue and weight gain must be screened for TSH levels. Hypothyroidism is no longer a rarity, and coal mine areas are no exception to this phenomenon. A population‑based epidemiological study of thyroid disorders in coal mine areas is an urgent need.

Antibiotics Resistance Prevalence of Helicobacter pylori Strains in Northwest China.

PurposeThis study aims to estimate the resistance rate of Helicobacter pylori (HP) to commonly used antibiotics and analyze the potential influencing factors in northwest regions of China.Patients and MethodsHP-positive patients visiting the outpatient department of multiple hospitals were enrolled in the study. Then, gastric mucosal biopsy specimens were collected for HP isolation, culture, and investigation of the resistance rate of HP to amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin by Epsilometer test (E-test) antibiotic susceptibility testing. In addition, multi-drug resistance, the influence of HP eradication history, age, and region of residence on drug resistance rate were analyzed.ResultsIn total, 198 HP clinical strains were successfully isolated and cultured. The resistance rates of amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin were 16.16%, 85.86%, 7.58%, 46.46%, and 55.05%, respectively. The multi-drug resistance rates demonstrated that dual and triple resistances were 30.30% and 22.73%, respectively. The quadruple resistance rate reached 9.60%. Our results revealed that the prior eradication history of HP significantly increased levofloxacin and clarithromycin resistance. Metronidazole and levofloxacin resistances significantly differed among different age groups, which presented an upward trend with increasing age. Drug resistance rates varied with geographic regions, especially amoxicillin and clarithromycin resistance, which were highest in Hexi Corridor and Longnan regions.ConclusionThe current situation of HP resistance to common antibiotics is severe. Tetracycline is the most sensitive antibiotic, followed by amoxicillin, the first choice for HP eradication. However, the eradication failure of HP may lead to an increase in the resistance rate. Therefore, it is necessary to strengthen the standardized diagnosis and treatment of HP to improve the primary eradication rate.

Is Estimation Of Blood Glucose By Glucometer More Reliable Than Laboratory Analysis? A Comparative Study Done At Rural Hospital Of Maharashtra

Abstract Introduction: Diabetes is a major public health problem that is approaching epidemic proportions globally. Self-monitoring of blood glucose (SMBG) by the American Diabetes Association (ADA) is promoted in diabetic patients so that they achieve and maintain specific glycemic goals. Objectives : To compare the blood glucose estimation methods; capillary blood and venous blood by glucometer, venous plasma glucose estimation by auto analyzer and to find variation in results. Material & Methods : 60 patients attending Outpatient department of JIIUs IIMSR and Noor hospital, Warudi, Badnapur, Maharashtra who were advised blood glucose estimation were selected. Finger prick (capillary) blood glucose & glucose estimation of venous blood was done by glucometer; and venous plasma glucose estimation was done by auto analyzer in laboratory. Result & Conclusion : Mean values of capillary glucose estimation by glucometer were higher than plasma glucose estimation in laboratory on auto analyzer and the difference was found to be statistically significant. Venous glucose estimation on glucometer gave high erroneous results as compared to plasma glucose estimation in laboratory.

Family Members’ Support Needs to Prevent and Manage Relapse of Mental Health Care Users Living with Schizophrenia in Gauteng, South Africa

Mental health care users (MHCUs) living with schizophrenia experience an altered reality with regard to cognition and perceptions. Research shows that between 37% and 58% of patients diagnosed with schizophrenia relapse due to poor treatment compliance; lack of insight into their illness; and non-adherence to medication. The aim of the current study was to explore and describe the views of family members on preventing and managing relapse of MHCUs, and their support needs with regard to preventing and managing relapse of MHCUs at a selected government psychiatric hospital in Gauteng, South Africa. An exploratory, descriptive and contextual research design was followed. Fourteen family members of MHCUs were purposively sampled from the hospital outpatient department. Data was collected through in-depth individual interviews. Ethical considerations were adhered to, and approval was obtained from the Institutional Review Board and gatekeepers. Written informed consent was obtained from each participant. The findings of the study indicated that violence, financial burden, emotional burden and stigmatisation by the community were challenges experienced by family members. The family members were of the view that substance use and non-adherence led to relapse of MHCUs. Thus, the family members viewed themselves as a source of emotional support who provided supervision and monitoring. Enhanced health care provider support and improved health care services to MHCUs and their family members are needed. Relapse could be addressed by means of a holistic integrated and multidisciplinary approach to the care, treatment and rehabilitation of MHCUs.

A study on suicidal tendency and their socio demographic profile among the patients attending the psychiatric outpatient department, tertiary care hospital, Nellore, SPSR Nellore district, Andhra Pradesh

Background: Suicide is one of the ten major causes of death in India. Intentional self-harm is also associated with long term risk for repeated attempts as well as death by suicide. Individuals differ in the degree to which risk and protective factors affect their propensity for engaging in suicidal behaviours. The present study seeks to explore about suicidal intent among the self-harm attempters.Methods: This was a hospital based cross-sectional study and includes both male and female patients attending the psychiatric outpatient department of government general hospital, Nellore. After obtaining the informed consent, the necessary data was obtained by a semi-structured interview schedule.Results: Descriptive analysis of the cases showed that those aged less than 30 years (49.3%), unmarried (52.0%), female subjects (52.0%), urban residents (51.3%) and those belonging to nuclear families (60.6%) were commonly involved. Organo-phosphorus poisoning was the commonly used method (30%). The psychological problems were the most common reason (40.0%) for attempting suicide. Mode of attempt, type of stress, existing physical illness and past psychiatric illness influenced the suicidal attempts.Conclusions: Gender specific differences were noted with regard to mode of attempt, type of stressors, physical illness, and past psychiatric illness. Young age groups are vulnerable for suicide. Identifying risk factors helps to design interventions to prevent further attempts.

Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis.

ObjectiveRegarding the effects and practical application of insulin pumps on patients with type 1 diabetes mellitus (T1DM), the real-world evidence is limited especially concerning the incidence of hypoglycemia. This study aimed to compare the efficacy of continuous subcutaneous insulin infusion (CSII) therapy with multiple daily injection (MDI) therapy on glycemic metrics evaluated by retrospective continuous glucose monitoring (CGM) in Chinese patients with T1DM.MethodsIn total, 362 T1DM Chinese patients from the outpatient department of the Second Xiangya Hospital, Central South University, who underwent intensive insulin therapy and used a retrospective CGM system were included in this retrospective cross-sectional study. Comprehensive analysis of clinical and biological features and retrospective CGM derived-metrics was performed on the 362 enrolled T1DM patients who underwent CSII (n = 61) or MDI (n = 301) therapy (defined as 4 or more insulin injections per day).ResultsOur findings demonstrated that patients who underwent CSII therapy, compared with those who received MDI therapy, had lower levels of hemoglobin A1c (HbA1c) and fasting blood glucose; moreover, CSII therapy was associated with better glycemic outcomes in terms of increasing time in range (TIR), decreasing time above range (TAR), and achieving CGM-associated targets of TIR ≥70% and TAR <25%. However, patients who underwent CSII therapy did not experience decreasing time below range (TBR), achieving CGM-associated targets of TBR <4%, and reduction of the risk of hypoglycemia as evidenced by comparing TBR and low blood glucose index (LBGI) between the two treatment regimens. The parameters of glycemic variability, such as standard deviation of glucose (SD), mean amplitude glycemic excursion (MAGE), and large amplitude glycemic excursion (LAGE) in T1DM patients who underwent CSII therapy outperformed.ConclusionOur results provided further evidence that CSII therapy is safe and effective for management of Chinese T1DM patients, which was confirmed by a lower HbA1c level and better CGM-derived metrics but no demonstration of improvment in the risk of hypoglycemia. To achieve more satisfactory glycemic outcomes through the utilization of CSII therapy for Chinese T1DM patients, a strong physician-patient relationship is essential.

Patient’s satisfaction in physiotherapy outpatient departments of Amhara regional comprehensive specialized hospitals, Ethiopia

BackgroundSatisfaction is basically the state of being gratified and act of fulfilling one's need or desires. Nowadays, evidence-based practice concept is prevailing and there has been a growing interest in the measurement of patient satisfaction in healthcare research. Patient satisfaction surveys provide several benefits for healthcare professionals. Assessing patient’s satisfaction with physiotherapy service could generate knowledge that can utilized for improving or maintaining quality service. Although a wide coverage and high emphasis givens to patient satisfaction studies in developed counties, there are few research’s done in Africa. This study aimed to assess satisfaction in physiotherapy service and identify predictors that affect satisfaction among patient treated in physiotherapy outpatient department.ObjectivesTo assess satisfaction in physiotherapy service and identify associated factors among patients in physiotherapy outpatient department in Amhara regional state comprehensive specialized hospitals.MethodInstitution based cross-sectional study was conducted among physiotherapy outpatients from April to June 2021, at three selected Comprehensive specialized hospitals. Data were collected by interviewing participants using semi-structured questionnaire. Patient satisfaction was determined by using Medrisk tool. Data were analyzed by using descriptive statistics and bivariate and multivariable logistic regression method were used to identify predictor factors.ResultA total of 409 participants with a response rate of 95% were included in this study. The overall satisfaction among physiotherapy outpatient attendee was 50.1% with 95% CI (46.2–55.7). Pain level (AOR = 5.59 95%CI (2.58–12.1), longitudinal continuity of care (AOR = 3.02 95%CI (1.46–6.62) and self-rated health improvement (AOR = 3.76, 95% CI (1.78–7.94) were significantly associated factors.ConclusionThe overall satisfaction in this study were found to be low in Amhara regional state comprehensive specialized hospitals. pain level, self-rated health improvement and longitudinal continuity of care were significantly associated factors.

Setting up a three-stage pre-endoscopy triage during the coronavirus disease 2019 pandemic: A multicenter observational study.

ObjectivesBetween May and July 2021, the coronavirus disease 2019 (COVID‐19) pandemic led to a sharp surge in community transmission in Taiwan. We present a three‐stage restructuring process of pre‐endoscopy triage at the beginning of the pandemic, which can support urgent endoscopic procedures while protecting endoscopy staff.MethodsThe pre‐endoscopy triage framework was set up with three checkpoints at the hospital entrance, outpatient department, and endoscopy unit, with a specific target patient population and screening methods. Relevant data included the number of endoscopic procedures performed, outpatient department visits, and performing screening methods such as temperature measurement, travel, occupation, contact, and clustering history checking, polymerase chain reaction assay, and rapid antigen test.ResultsForehead temperature measurement and verification of travel, occupation, contact, and clustering history provided rapid, easy, and early mass screening of symptomatic patients at the hospital entrance. During the pandemic, outpatient department visits and endoscopic procedures decreased by 37% and 64%, respectively. The pre‐endoscopy screening methods used displayed regional variations in COVID‐19 prevalence. Among 16 endoscopy units with a community prevalence of ≥ 31.04 cases per 100,000 residents, 12 (75%) used polymerase chain reaction assay and four (25%) used rapid antigen test to identify asymptomatic patients before endoscopy. Of 6540 pre‐endoscopy screening patients, 15 (0.23%) tested positive by laboratory testing. No endoscopy‐related nosocomial COVID‐19 infections were reported during the pandemic.ConclusionsWe present a three‐stage pre‐endoscopy triage based on the local laboratory capacity, medical resources, and community prevalence. These measures could be useful during the COVID‐19 pandemic.

Clinical characteristics of the severe acute respiratory syndrome coronavirus 2 omicron variant compared with the delta variant: a retrospective case-control study of 318 outpatients from a single sight institute in Japan.

BackgroundClinical characteristics, including laboratory parameters, of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant have been limited.MethodsThis retrospective case-control study was conducted in a single hospital. Patients with coronavirus disease 2019 (COVID-19) who visited the Asahikawa City Hospital outpatient department as new patients and underwent blood tests were included in this study. We analyzed the data from January 2022 to April 2022 during the Omicron phase and from April 2021 to October 2021 during the Delta phase. Patients who were treated at other hospitals after visiting our hospital were excluded. All blood tests were performed before treatment for COVID-19 was initiated. Demographic information, laboratory data, and clinical courses were extracted from electronic medical records. We matched the two groups by age and comorbidities and compared their characteristics. We also analyzed factors associated with pneumonia in the Omicron phase.ResultsA total of 151 Omicron patients and 167 delta patients were analyzed in this study. The mean age, rate of comorbidities, and vaccination were significantly higher in the Omicron group. The number of patients with pneumonia or those requiring oxygen, admissions, or both was significantly lower in the Omicron group. Lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, aspartate aminotransferase (AST), and neutrophil-to-lymphocyte ratio (NLR) levels were significantly lower in the Omicron group. Compared with the mild symptom and pneumonia groups in the Omicron group, older age, higher body mass index (BMI), higher non-vaccination, higher LDH, and higher CRP levels were associated with the pneumonia group.ConclusionThe Omicron variant is associated with a reduction in hospitalization and the risk of pneumonia compared to the delta variant in a real-life clinical setting. In the Omicron variant, the risk of pneumonia is related to high-risk factors, laboratory data such as LDH and CRP levels, and no vaccination.

Relation between Serum Ferritin Level and the Risk of Acute Myocardial Infarction.

An association between increased incidence of acute myocardial infarction (AMI) and elevated levels of stored iron concentration was recently reported. The data in India regarding association between AMI and levels of serum ferritin are lacking. To study the association between serum ferritin level and risk of AMI. The present case-control study was conducted from May 2016 to October 2017 on 64 patients aged ≥30 years of either sex who were diagnosed with AMI (group I) and 60 controls (group II). Patients who attended outpatient department of hospital for minor illnesses, routine health checkups, and persons accompanying patients were selected randomly as controls. The controls had no signs of AMI or coronary heart disease (CHD) on clinical examination and had normal electrocardiogram (ECG). Quantitative measurement of serum ferritin was done in all subjects. The Chi-square or Fisher's exact test and unpaired t-test were used to compare the categorical and quantitative variables, respectively. The independent association of serum ferritin with AMI was tested using multivariate logistic regression analysis. The mean serum ferritin level was significantly higher in group I (203.5 µg/L) as compared to group II (111.8 µg/L). In group I, 82.9% patients had serum ferritin ≥150 µg/L as compared to group II (15.0%) with p-value = 0.001. Multivariate analysis showed history of smoking, body mass index (BMI) &gt;25 kg/m2 , serum ferritin levels &gt;200 µg/L, and high-density lipoprotein (HDL) cholesterol level &lt;35mg/dL were independent and significant determinants of AMI. There was an association between elevated serum ferritin levels with AMI.

Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea.

This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals aged 18 years old and younger were used. Of the participants, 87.3% had private medical insurance. Of the 1000 children, in an average month, 404 visited a clinic, 67 visited a hospital outpatient department (OPD), 49 visited an OPD in a tertiary hospital, 11 received emergency care, 5 received inpatient care in a hospital, and 9 were hospitalized. The generalized estimating equation models adjusted for age, sex, economic status, and pediatric comorbidity index were used for multivariate analysis. Receiving ambulatory care services in clinics was significantly more likely among children and adolescents with private medical insurance (adjusted odds ratio [aOR] = 1.16 [95% confidence interval [CI]: 1.00–1.35]). Receiving ambulatory care services in clinics was significantly more likely among indemnity type policyholders (aOR = 1.23 [1.05–1.45]) and single policyholders (aOR = 1.18 [1.00–1.37]). Countries with national health insurance schemes should continuously practice the proper regulation and management of PMI, including reviewing PMI compensation measures, NHI reimbursement standards, and consumers’ perspectives on NHI and PMI.

Willingness to receive COVID-19 vaccine and associated factors among adult chronic patients. A cross-sectional study in Northwest Ethiopia.

People with pre-existing chronic diseases are more likely to acquire COVID-19 infections, which can be fatal, and die from COVID-19 illness. COVID-19 vaccination will benefit those at a higher risk of developing complications and dying from the disease. This study aimed to determine chronic patients' willingness to receive a COVID-19 vaccine and the factors that influence their willingness. An institutional-based cross-sectional study was conducted among 423 adult chronic patients in the University of Gondar specialized hospital outpatient departments. The participants were chosen using systematic random sampling methods with an interval of 5. Face-to-face interviews were used to collect data from eligible respondents. Epi-data version 4.6 and SPSS version 25 were used for the data entry data analysis. Bivariable and multivariable binary logistic regression analyses were used to evaluate the relationship between the dependent and independent factors. An odds ratio with 95 percent confidence intervals and a P-value was used to determine the association's strength and statistical significance. Out of 401 respondents, 219 (54.6%) with [95% CI (49.7-59.5%)] of study participants were willing to receive the COVID-19 vaccination. Being a healthcare worker (AOR = 2.94, 95% CI: 1.24-6.96), Lost family members or friends due to COVID-19 (AOR = 2.47, 95% CI: 1.21-5.00), good knowledge about COVID-19 vaccine (AOR = 2.44, 95% CI: 1.37-4.33), favorable attitude towards COVID-19 vaccine (AOR = .8.56 95% CI: 4.76-15.38), perceived suitability of the COVID-19 infection (AOR = 2.94, 95% CI: 1.62-5.33) and perceived benefit of the COVID-19 vaccine (AOR = 1.89, 95% CI: 1.08-3.31), were found to be a significant association with the willingness to receive the COVID-19 vaccine among chronic patients. This study confirms that around 55% of adult chronic patients were willing to receive the COVID-19 vaccine. Providing health education for chronic patients to emphasize the knowledge and attitude of the COVID-19 vaccine and raise patients' perceived risk of COVID-19 and the benefit of the COVID-19 vaccine could be recommended to improve their willingness to COVID-19 vaccination.

Knowledge, Attitude, and Practices Toward Tuberculosis Among Hospital Outpatients in Kabul, Afghanistan.

BackgroundTuberculosis (TB) is a high-burden respiratory infectious disease. There was a sharp decline in the number of confirmed TB cases during the pandemic; this is likely to be influenced by the COVID-19 pandemic response, with under-reporting due to resource diversion. There are typically 13,000 tuberculosis-associated deaths in Afghanistan annually, with significant problems posed by drug-resistant TB.MethodA cross-sectional descriptive study was conducted in Afghanistan on Kabul residents who visited the adult outpatient departments of public hospitals for any health-related reason from 1st January to 20th March 2022. The study scored their knowledge, attitude, and practices (KAP) toward tuberculosis. The sample size was calculated using Epi-Info, and the minimum sample size was 385. The sampling method is chosen the non-probability convenient sampling for data gathering. Data were analyzed using SPSS version 28, and we used the Mann-Whitney test, Chi-square or fisher extract test, spearman correlations, and binary logistic regression model.ResultsOf 829 participants, 450 (54.3%) were males and 379 (45.7) females. The median age was 28 years, and 63.3% were married. Most participants were unemployed (75.5%), but 54% had a monthly income >3,000 Afghanis, indicating the reliance on family. By TB knowledge score, 727 (87.7%) participants had good knowledge, and 800 (96.5%) participants had a positive attitude toward treatment and control. Only 2 participants reported poor practices regarding prevention. Regarding the binary logistic regression, young age, being a male, belonging to the “1,000–3,000” Afghani monthly income category, and having a positive attitude were significant predictors of good TB knowledge (P-value = 0.009, 0.000, 0.003, and 0.009), respectively. A positive attitude was expected to have good knowledge 6.035 times more than a negative attitude (95% CI: 1.572–23.167).ConclusionThe study findings highlighted that outpatients in Kabul had good knowledge, attitude, and practice toward TB. More studies are needed to highlight KAP in different Afghan populations, including in other parts of the country.

Efficacy of Mrudu Samvahana (Forehead Massage) over Takra Dhara (Buttermilk Dripping Therapy) in Anxiety and Stress Induced Essential Hypertension – A Randomized Clinical Trial.

Blood pressure level measuring above 140/90 mm of Hg is termed as hypertension. Hypertension is associated with various risk factors and also is mainly responsible for mortality in industrialized countries. The treatment for hypertension in modern science is palliative in nature. Many of these, along with its effectiveness in controlling the blood pressure, cause adverse side effects; hence the need for the hour is an alternate therapy with no potential side effects. Ayurveda has potential medicines to alleviate hypertension without causing any side effects. The study was to evaluate clinical efficacy of two Ayurveda procedures Mrudu Samvahana and Takradhaara in essential hypertension. The study included a total of 40 patients, attending the Outpatient department of KLE Ayurveda hospital, randomized into Group A and Group B of 20 each. The patients in group A received Mrudu samvaahana with Murchita tila taila which was performed 20 minutes per day for 7 days. The patients in group B received Takra dhara with Amalaki siddha takra which was performed 40 minutes per day for 7 days. Statistical analysis revealed that both groups Mrudu Samvahana and Takradhara showed significant (P&lt;0.0001) results determined by unpaired T test in objective parameters. Between the group assessment. revealed that Takra dhara has shown better results compared to mrudu samvahana in reduction of systolic and diastolic blood pressure. (P&lt;0.0048).

Reduced Healthcare Resource Utilization in Patients with Opioid Use Disorder in the 12Months After Initiation of a Prescription Digital Therapeutic.

Background and AimsreSET-O, an FDA-authorized prescription digital therapeutic (PDT) delivering cognitive behavioral therapy and contingency management to patients with opioid u®se disorder (OUD), may help improve clinical outcomes. One-year differences in healthcare resource utilization (HCRU) and costs post-PDT initiation were evaluated.MethodsRetrospective analysis of healthcare claims data compared all-cause HCRU (across hospital facility encounters [sum of inpatient stays, treat-and-release emergency department [ED] visits, partial hospitalizations, and hospital outpatient department visits] and clinician services [procedure categories]) after PDT initiation (index) between reSET-O patients and controls. Overall and Medicaid-specific differences in HCRU, costs, and buprenorphine adherence were evaluated.FindingsCohorts included 901 reSET-O patients (median age 36 years, 62.4% female, 73.9% Medicaid) and 978 controls (median age 38 years, 51.1% female, 65.4% Medicaid). Compared to the control group, the reSET-O group experienced 12% fewer total unique hospital encounters (non-significant), driven by 28% fewer inpatient stays (IRR 0.72; 95% CI 0.55–0.96; P = 0.02), 56% fewer hospital readmissions [IRR 0.44; 95% CI 0.20–0.93; P = 0.033]), and 7% fewer ED visits (IRR 0.93; 95% CI 0.79–1.09; P = 0.386). Total clinician services increased by 1391 events versus controls. Differences were greater among the Medicaid patients. Adjustment for concomitant baseline substance use and mental health disorders resulted in similar HCRU incidence rate ratios. Changes in all-cause HCRU drove per-patient per-year cost differences of − $2791 versus controls (− $3832 versus Medicaid controls). Adjusted mean medication possession ratio was 0.848 (SE 0.0118) at 12 months for reSET-O patients, which was significantly higher than controls (0.761 [SE 0.0108]; P < 0.001).ConclusionsUse of reSET-O is associated with significant and durable real-world reductions in ED and inpatient (including readmissions) utilization, reduced net costs, and increased clinician services and buprenorphine adherence. Differences in costs versus controls were greatest among Medicaid patients.Infographic Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02217-y.

The Lipid Profiles in Different Characteristics of Women with PCOS and the Interaction Between Dyslipidemia and Metabolic Disorder States: A Retrospective Study in Chinese Population.

PurposeTo exhibit the lipid profiles in PCOS women with different characteristics and to access correlations between alternation of key lipid parameters and characteristics of PCOS.DesignA retrospective study.ParticipantsA total of 700 PCOS women were included.MethodsRetrospective study on 700 women (age 24.6 ± 4.7 years), diagnosed with PCOS in the outpatient department of Obstetrics and Gynecology Hospital of Fudan University according to Rotterdam criteria. Anthropometric features, hormone levels, lipid levels, and metabolic parameters were measured and compared between PCOS patients with different characteristics.ResultsThere was a high prevalence of dyslipidemia among Chinese PCOS patients (41.3%), and the most common pattern was low HDL. Patients with clinical hyperandrogenism presented with significantly decreased HDL and Apo-A levels. The levels of TG, LDL, Apo-B, TG/HDL, and Apo-B/Apo-A were significantly increased in the insulin resistance subgroup. The levels of TC and TG were significantly increased in the dysglycemia and T2DM women. And in general, the levels of TG, and Apo-B had an increasing trend with BMI. Moreover, AI, TG/HDL, and Apo-B/Apo-A ratios were associated with some characteristics of PCOS, such as insulin resistance, and obesity.ConclusionThe PCOS women with different characteristics presented with different lipid profiles, and there is a complex correlation between lipid metabolism and PCOS characteristics, which may explain the increased risk of long-term cardiovascular disease. Regular screening of blood lipids is essential for PCOS women. Identification of optimal subgroups in PCOS patients that need lipid-lowering treatment and therapeutic effectiveness is worth exploring.